Tissue Fillers and Neurotoxins

Dr. Jewell offers injectables to improve facial wrinkling from muscular action and restore facial volume that is lost with aging. Currently, there are two excellent FDA-approved neurotoxins available, Botox Cosmetic® www.botoxcosmetic.com and Dysport® www.dysportusa.com. Dr. Jewell has extensive experience with both varieties and can help you decide which is best for you. Regarding tissue fillers to restore facial volume, there are many options also. These include the hyaluronic acid-based fillers such as Restylane® www.restylaneusa.com, Perlane® www.restylaneusa.com, Juvederm Ultra/Ultra Plus® www.juvederm.com, and Prevelle® . These fillers are compounded with lidocaine to reduce discomfort during injection. Other synthetic injectables that are used include Radiesse®  and Sculptra® . Dr. Jewell also offers Selphyl® www.selphyl.com a new tissue filler that is made from components found in your own blood. Your own fat (autologous fat grafting) is another option, but requires a surgical procedure (liposuction) to collect fat and prepare it for injection.

Who will be doing the injections?

Dr. Jewell performs his injections for tissue fillers and neurotoxins himself. He also has trained nurse injectors for neurotoxins that work under his direction, once a treatment plan has been developed.

Is Selphyl® a new filler?

Using your own Blood is the latest anti-ager. The innovative Selphyl® System www.selphyl.com borrows upon the notion of platelet rich plasma (PRP). PRP has been around for the last decade used to repair damaged knees and ankles which is now being applied as a tissue filler. Blood platelets contain growth factors that regenerate damaged tissue. A small amount of your own blood is drawn, and the platelets and fibrin are separated into a concentrate known as the matrix which is then injected into the skin depressions, acne scars, wrinkles and folds. Upon injection the platelet releases growth factors that trigger the fibroblast proliferation which in turn creates volume and rejuvenation of the skin.

I have heard about the “instant” facelifts using injectables. Does it work?

“Liquid lifts”, on the right person is a good option. Fillers can increase volumne, in depleated areas of the face and fill in lines and wrinkles. These are temporary and are not able to do what surgery can when a person is in need of a facelift.

Can I use my own fat as a tissue-filler in the face?

Fat grafting to enhance facial volume is an excellent option for some patients. This involves a liposuction procedure to obtain fat graft from an area such as your abdomen. The fat is then injected as a filler to restore facial volume. While fat can be used to enhance lip contours, Dr. Jewell believes that synthetic fillers such as Restylane® or Juve’derm® offer better outcomes, with less bruising, swelling, or lumps. Not all of the fat graft survives and it is usually necessary to undergo a second fat graft procedure in order to optimize your results. Fat grafting is a surgical procedure versus synthetic fillers that can be injected in a treatment room.

Are permanent fillers a good idea?

Dr. Jewell and the Physicians Coalition for Injectable Safety believe that while permanent fillers seem like a good option, there are substantive drawbacks and late term risks that occur years following injection. Permanent fillers such as Artefill® www.artefill.com or injectable silicone when used off-label have been associated with late-term complications such as infections, granulomas and scarring. Permanent fillers can produce permanent, devastating complications years after injection.